Diabetes mellitus is a major negative determinant of coronary plaque regression during statin therapy in patients with acute coronary syndrome - Serial Intravascular Ultrasound Observations From the Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome Trial (the JAPAN-ACS Trial)

Takafumi Hiro, Takeshi Kimura, Takeshi Morimoto, Katsumi Miyauchi, Yoshihisa Nakagawa, Masakazu Yamagishi, Yukio Ozaki, Kazuo Kimura, Satoshi Saito, Tetsu Yamaguchi, Hiroyuki Daida, Masunori Matsuzaki

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Abstract

Background: The Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome (JAPAN-ACS) trial has found that early aggressive statin therapy in patients with acute coronary syndrome (ACS) significantly reduces the plaque volume (PV) of non-culprit coronary lesions. The purpose of the present study was to evaluate clinical factors that have an impact on plaque regression using statin therapy. Methods and Results: Serial intravascular ultrasound observations over 8-12 months were performed in 252 ACS patients receiving pitavastatin or atorvastatin. Linear regression analysis identified the presence of diabetes mellitus (DM) and PV at baseline as inhibiting factors, and serum remnant-like particle-cholesterol level at baseline as a significant factor significantly affecting the degree of plaque regression. Significant correlation between % change of PV and low-density lipoprotein cholesterol (LDL-C) level was found in patients with DM (n=73, P<0.05, r=0.4), whereas there was no significant correlation between the 2 parameters in patients without DM (n=178). Conclusions: The regression of coronary plaque induced by statin therapy after ACS was weaker in diabetic patients than their counterparts. Moreover, vigorous reduction of the LDL-C levels might induce a greater degree of plaque regression in ACS patients with DM.

Original languageEnglish
Pages (from-to)1165-1174
Number of pages10
JournalCirculation Journal
Volume74
Issue number6
DOIs
Publication statusPublished - 18-06-2010

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Acute Coronary Syndrome
Diabetes Mellitus
Japan
LDL Cholesterol
Therapeutics
Atorvastatin Calcium
pitavastatin
Linear Models
Regression Analysis
Serum

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Hiro, Takafumi ; Kimura, Takeshi ; Morimoto, Takeshi ; Miyauchi, Katsumi ; Nakagawa, Yoshihisa ; Yamagishi, Masakazu ; Ozaki, Yukio ; Kimura, Kazuo ; Saito, Satoshi ; Yamaguchi, Tetsu ; Daida, Hiroyuki ; Matsuzaki, Masunori. / Diabetes mellitus is a major negative determinant of coronary plaque regression during statin therapy in patients with acute coronary syndrome - Serial Intravascular Ultrasound Observations From the Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome Trial (the JAPAN-ACS Trial). In: Circulation Journal. 2010 ; Vol. 74, No. 6. pp. 1165-1174.
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abstract = "Background: The Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome (JAPAN-ACS) trial has found that early aggressive statin therapy in patients with acute coronary syndrome (ACS) significantly reduces the plaque volume (PV) of non-culprit coronary lesions. The purpose of the present study was to evaluate clinical factors that have an impact on plaque regression using statin therapy. Methods and Results: Serial intravascular ultrasound observations over 8-12 months were performed in 252 ACS patients receiving pitavastatin or atorvastatin. Linear regression analysis identified the presence of diabetes mellitus (DM) and PV at baseline as inhibiting factors, and serum remnant-like particle-cholesterol level at baseline as a significant factor significantly affecting the degree of plaque regression. Significant correlation between {\%} change of PV and low-density lipoprotein cholesterol (LDL-C) level was found in patients with DM (n=73, P<0.05, r=0.4), whereas there was no significant correlation between the 2 parameters in patients without DM (n=178). Conclusions: The regression of coronary plaque induced by statin therapy after ACS was weaker in diabetic patients than their counterparts. Moreover, vigorous reduction of the LDL-C levels might induce a greater degree of plaque regression in ACS patients with DM.",
author = "Takafumi Hiro and Takeshi Kimura and Takeshi Morimoto and Katsumi Miyauchi and Yoshihisa Nakagawa and Masakazu Yamagishi and Yukio Ozaki and Kazuo Kimura and Satoshi Saito and Tetsu Yamaguchi and Hiroyuki Daida and Masunori Matsuzaki",
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Diabetes mellitus is a major negative determinant of coronary plaque regression during statin therapy in patients with acute coronary syndrome - Serial Intravascular Ultrasound Observations From the Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome Trial (the JAPAN-ACS Trial). / Hiro, Takafumi; Kimura, Takeshi; Morimoto, Takeshi; Miyauchi, Katsumi; Nakagawa, Yoshihisa; Yamagishi, Masakazu; Ozaki, Yukio; Kimura, Kazuo; Saito, Satoshi; Yamaguchi, Tetsu; Daida, Hiroyuki; Matsuzaki, Masunori.

In: Circulation Journal, Vol. 74, No. 6, 18.06.2010, p. 1165-1174.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Diabetes mellitus is a major negative determinant of coronary plaque regression during statin therapy in patients with acute coronary syndrome - Serial Intravascular Ultrasound Observations From the Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome Trial (the JAPAN-ACS Trial)

AU - Hiro, Takafumi

AU - Kimura, Takeshi

AU - Morimoto, Takeshi

AU - Miyauchi, Katsumi

AU - Nakagawa, Yoshihisa

AU - Yamagishi, Masakazu

AU - Ozaki, Yukio

AU - Kimura, Kazuo

AU - Saito, Satoshi

AU - Yamaguchi, Tetsu

AU - Daida, Hiroyuki

AU - Matsuzaki, Masunori

PY - 2010/6/18

Y1 - 2010/6/18

N2 - Background: The Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome (JAPAN-ACS) trial has found that early aggressive statin therapy in patients with acute coronary syndrome (ACS) significantly reduces the plaque volume (PV) of non-culprit coronary lesions. The purpose of the present study was to evaluate clinical factors that have an impact on plaque regression using statin therapy. Methods and Results: Serial intravascular ultrasound observations over 8-12 months were performed in 252 ACS patients receiving pitavastatin or atorvastatin. Linear regression analysis identified the presence of diabetes mellitus (DM) and PV at baseline as inhibiting factors, and serum remnant-like particle-cholesterol level at baseline as a significant factor significantly affecting the degree of plaque regression. Significant correlation between % change of PV and low-density lipoprotein cholesterol (LDL-C) level was found in patients with DM (n=73, P<0.05, r=0.4), whereas there was no significant correlation between the 2 parameters in patients without DM (n=178). Conclusions: The regression of coronary plaque induced by statin therapy after ACS was weaker in diabetic patients than their counterparts. Moreover, vigorous reduction of the LDL-C levels might induce a greater degree of plaque regression in ACS patients with DM.

AB - Background: The Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome (JAPAN-ACS) trial has found that early aggressive statin therapy in patients with acute coronary syndrome (ACS) significantly reduces the plaque volume (PV) of non-culprit coronary lesions. The purpose of the present study was to evaluate clinical factors that have an impact on plaque regression using statin therapy. Methods and Results: Serial intravascular ultrasound observations over 8-12 months were performed in 252 ACS patients receiving pitavastatin or atorvastatin. Linear regression analysis identified the presence of diabetes mellitus (DM) and PV at baseline as inhibiting factors, and serum remnant-like particle-cholesterol level at baseline as a significant factor significantly affecting the degree of plaque regression. Significant correlation between % change of PV and low-density lipoprotein cholesterol (LDL-C) level was found in patients with DM (n=73, P<0.05, r=0.4), whereas there was no significant correlation between the 2 parameters in patients without DM (n=178). Conclusions: The regression of coronary plaque induced by statin therapy after ACS was weaker in diabetic patients than their counterparts. Moreover, vigorous reduction of the LDL-C levels might induce a greater degree of plaque regression in ACS patients with DM.

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U2 - 10.1253/circj.CJ-09-0766

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EP - 1174

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

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